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CONTENTS

About the Editor xi

About the Contributors xiii
Introduction xxv
Michael P. Dentato

PART I OVERVIEW: BUILDING KNOWLEDGE

FOR PRACTICE

1. A History of Community: Marching Toward LGBTQ Equality 3

Jean E. Balestrery

2. Understanding Differences and Definitions: From Oppression

to Sexual Health and Practice 26
Elizabeth B. Russell and Pamela A. Viggiani

3. Advancing Social and Economic Justice 49

Kirsten Havig, Anthony P. Natale, David A. McLeod,
and Megan Gandy-​Guedes
vii

PART II CONSIDERATIONS ACROSS THE LIFESPAN

4. Identity Development 71
Tyler M. Argüello

5. The Coming Out Process 97

Mark Smith, Tyler M. Argüello, and Michael P. Dentato

6. Trauma Impacts on LGBTQ People: Implications for Lifespan Development 118

Megan Gandy-​Guedes, Kirsten Havig, Anthony P. Natale,
and David A. McLeod

7. Strengths-​Affirming Practice with LGBTQ Youth 137

Brian L. Kelly and G. Allen Ratliff

8. Dating, Relationships, and Family Issues 159

Michael P. Dentato, Tyler M. Argüello, and Mark Smith

9. Employment, Stress, and the Strengths Perspective 197

Trevor G. Gates

10. Aging within the LGBT Community: An Exploration of Life’s Challenges 211
Marcia Spira, John Orwat, and Shaina Knepler-​Foss

PART III AFFIRMING LGBTQ PRACTICE

APPROACHES

11. Affirming and Strengths-​Based Models of Practice 235

Trevor G. Gates and Brian L. Kelly

12. Incorporating Minority Stress Theory into Clinical Practice

with Sexual-​Minority Populations 249
Edward J. Alessi and Eric Hartman

13. Practice with the Lesbian Community: A Roadmap to Effective Micro,

Mezzo, and Macro Interventions 266
Gayle Mallinger

viii • Contents
ix

14. Practice with the Gay Male Community 286

Michael P. Dentato, Tyler M. Argüello, and Courtney Wilson

15. Practice with the Bisexual Community 315

Kristin S. Scherrer and Lacey D. Clark

16. Practice with Transgender and Gender-​Nonconforming Clients 333

Ashley Austin

17. Practice with the Queer Community 351

M. Alex Wagaman

18. Building Strengths-​Based and Empowering Continuums of

Care for LGBTQ Youth 366
Shelley L. Craig and Lauren B. McInroy

19. The Intersection of Policy and Practice: Advancing

Civil Rights Equality and Equity 383
Anthony P. Natale, Kirsten Havig, Megan Gandy-​Guedes,
and David A. McLeod

PART IV HEALTH AND MENTAL HEALTH FACTORS

20. An Examination of Health and Mental Health Factors Impacting

the LGBTQ Community 409
Sarah R. Young and Marcie Fisher-​Borne

21. LGBTQ People of Color with Mental Health Conditions:

Considering Intersectionalities 430
Lynn C. Holley and De’Shay Thomas

22. Substance Use and Addiction 452

Natasha S. Mendoza

23. Understanding the Impact of Intimate Partner Violence: Trends,

Frameworks, and Treatments 475
David A. McLeod, Kirsten Havig, Megan Gandy-​Guedes,
and Anthony P. Natale

Contents • ix
x

24. Health Disparities, HIV/​AIDS, and Framing a Public Health Agenda 494
Ian W. Holloway and Sid P. Jordan

PART V APPENDICES

Appendix A. Signs, Symbols, and Subcultures 523

Appendix B. Notable LGBTQ Individuals 526
Appendix C. Important Modern LGBTQ Historical Events 529
Appendix D. National and International Resources and Websites 531

Index 537

x • Contents
xi

ABOUT THE EDITOR

Michael Philip Dentato, PhD, MSW

Assistant Professor, School of Social Work, Loyola University Chicago
Dr. Dentato received his bachelor of arts and master of social work degrees from Fordham
University in New York City. He earned his PhD in social work from Loyola University
Chicago examining the impact of minority stress on substance use and sexual risk among men
who have sex with men. Dr. Dentato is an assistant professor in the School of Social Work at
Loyola and over the past 12 years has taught at institutions including Barry University, Ellen
Whiteside McDonnell School of Social Work in Miami Shores, Florida, where he was also the
BSW program director; the University of Illinois, Jane Addams College of Social Work; and
the University of Chicago’s School of Social Service Administration. Dr. Dentato’s research
and scholarship centers around three domains including (a) the assessment of health and
health disparities among sexual-​minority populations, (b) the preparedness of social work
students to provide affirming services for the LGBTQ community, and (c) the impact of macro
practice, interprofessional education, effective nonprofit leadership, and service provision
for vulnerable communities. Dr. Dentato is co-​principal investigator for the SBIRT training
program at Loyola University Chicago, funded by The Substance Abuse and Mental Health
Services Administration. He has more than 20 years of direct service and consultant experience
including clinical, administrative, and policy work throughout his tenure in New York City,
Miami, and Chicago.
Dr. Dentato is currently a research affiliate for the Center for Health, Identity, Behavior and
Prevention Studies at New York University’s Steinhardt School of Culture, Education and Human
Development; Ambassador at the Institute for Transformative Interprofessional Education at
Loyola University Chicago; associate editor for Behavioral Medicine; and an associate faculty
member with the women’s studies and gender studies program at Loyola University Chicago. He
is the former co-​chair of the Council on Social Work Education’s Council on Sexual Orientation
and Gender Identity and Expression, as well as former president of the board of directors for Test
Positive Aware Network. Dr. Dentato resides in Chicago with his husband, Domingo Gonzales III.
xii
xii

ABOUT THE CONTRIBUTORS

Edward J. Alessi, PhD, LCSW

Assistant Professor, School of Social Work, Rutgers University
Dr. Alessi’s scholarship (a) investigates the effect of minority stress on the mental health of sexual-​
and gender-​minority populations, (b) examines mental health practitioners’ use of affirmative
practice, and (c) seeks to advance clinical practice with marginalized and oppressed populations.
His research has been published in journals such as The Journal of Sex Research, Psychotherapy,
Psychotherapy Research, and Psychological Trauma: Theory, Research, Practice, and Policy. Dr. Alessi
also served as guest editor for the Clinical Social Work Journal’s first special issue on clinical
practice with LGBTQ populations. A clinical social worker since 2001, he has worked primarily in
outpatient mental health and has been an independent practitioner since 2004. Dr. Alessi received
his PhD in clinical social work from New York University and his master of science in social work
from Columbia University.
Tyler M. Argüello, PhD, DCSW, LCSW, ACSW
Assistant Professor, College of Health and Human Services, Division of Social Work, California State
University at Sacramento
Dr. Argüello’s research and clinical work is a transdisciplinary project that concerns communicative
practices, queer theory, and the production of identities, sex/​ualities, and health disparities,
namely HIV. Currently, Dr. Argüello studies intergenerational stress and divides within queer
populations and is the principal investigator on multiple critical theory–​driven and multimedia
studies on HIV Stress Exchange, AIDS Survivor Syndrome, and long-​term survivorship of queer
men, inclusive of all HIV statuses. Dr. Argüello has been a practicing social worker for more than
20 years, primarily around community mental health and HIV. He teaches courses in difference
and social justice, advanced clinical practice, psychodiagnostics, and qualitative research. He is a
licensed independent clinical social worker, with a diplomate in clinical social work, and holds a
BA (Spanish), BASW, MSW, and PhD (social welfare), all from the University of Washington,
Seattle.
xvi

Ashley Austin, PhD, LCSW

Associate Professor and Director of the Center for Human Rights and Social Justice in the School of
Social Work, Barry University
Dr. Austin’s research and practice interests revolve around reducing disparities in health and
well-​being among sexual-​and gender-​diverse individuals. Dr. Austin’s clinical practice and
community education is rooted in a transgender affirmative framework. Dr. Austin is involved
in multiple collaborations aimed at improving the delivery of transgender affirmative social work
education and practice. In particular, Dr. Austin’s clinical work is focused on the development
and dissemination of a transgender affirmative cognitive behavioral therapy approach that targets
the specific mental and behavioral health needs of gender-​diverse clients. This model integrates
an affirmative framework with empirically supported strategies to address minority stress and
develop positive coping. Dr. Austin is also actively involved in creating a transgender-​inclusive
campus and community by bringing events such as the Transgender Day of Remembrance and
Transgender Week of Awareness to her university’s campus and advocating for gender-​inclusive
policies and practices.
Jean E. Balestrery, PhD, MA, MSW
Assistant Clinical Professor, Department of Sociology and Social Work, Northern Arizona University
Dr. Balestrery earned her PhD in social work and anthropology from the University of
Michigan, her master of arts in anthropology from the University of Michigan, her master
of social work from the University of Washington, and her bachelor of arts from Brown
University. Dr. Balestrery is an interdisciplinary scholar whose research aims to improve health
and social service outcomes particularly for marginalized communities. Her research, which
is informed by many years of practice experience, addresses health, aging, clinical practice,
service delivery systems, and intercultural communication in a diverse global society. She
was selected in 2015 as a scholar-​participant for the Translational Health Disparities course
at the National Institute of Minority Health Disparities in Bethesda, Maryland, and as an
ambassador with the Gerontological Society of America for a US–​China delegation at the first
annual Healthy Ageing and Society research symposium in Suzhou, China. Dr. Balestrery has
addressed Native health disparities as a Spirit of Eagles Hampton Faculty Fellow and LGBTQ
community issues as a councilor on the Council on Sexual Orientation and Gender Identity
and Expression with the Council on Social Work Education. Strengthening linkages between
research, teaching, and practice, Dr. Balestrery conducts consultations and trainings for
community-​based stakeholders.
Lacey D. Clark, MSW
Lecturer, Department of Social Work, Metropolitan State University of Denver
Ms. Clark received her bachelor of arts in psychology and master of social work degrees at
Binghamton University in New York. Ms. Clark’s social work practice experiences relate primarily
to mental health issues with adults and youth, involving multiple practice modalities, including
work with individuals, families, groups, and communities. Ms. Clark has engaged in collaborative
research, including evaluation research and qualitative research projects on topics such as sexuality,
culturally competent practice, and diversity in doctoral education. Ms. Clark has taught BSSW
and MSW courses, including research methods and practice evaluation, diversity, and electives

xiv • About the Contributors

xv

that focus on gender and sexuality. Ms. Clark’s academic interests also include the role of research
in social work practice, addressing issues of diversity and marginalization in the social work
curriculum and classroom, and online pedagogy.
Shelley L. Craig, PhD, LCSW
Associate Professor and Associate Dean, Factor-​Inwentash Faculty of School of Social Work, University
of Toronto
Canada Research Chair in Sexual and Gender Minority Youth
Dr. Craig’s research focuses on the social determinants of health and mental health and the
impact of the service delivery system on vulnerable populations. Her primary specializations are
(a) the needs of sexual-​and gender-​minority youth and subsequent program development and
service delivery, (b) the roles and interventions used by health social workers to impact the social
determinants of health, and (c) developing competent social work practitioners through effective
social work education. Dr. Craig is a registered and licensed clinical social worker with a particular
expertise in delivering effective services for vulnerable populations. Selected experiences over her
25 years of practice include founder and executive director of the Alliance for LGBTQ Youth,
executive director of ALSO for Out Youth, medical social worker in the emergency care center of
a community hospital, and director of a domestic violence shelter.
Dr. Craig has been the recipient of numerous awards, including the Inspirational Social Work
Leader 2015, Ontario Association of Social Workers; Fellow, the Society for Social Work Research;
the Excellence in Research Scholarship Award from the Council of Sexual Orientation and Gender
Identity/​Expression; National Association of Social Workers Student Social Worker of the Year; and
the Gay and Lesbian Adolescent Social Services National Person of Impact. She is particularly proud
that several of her students and mentees have also become Student Social Worker(s) of the Year.
Marcie Fisher-​Borne, PhD, MSW, MPH
Program Director and Co-​Principal Investigator of the Vaccinate Adolescents against Cancers Project,
American Cancer Society
Assistant Professor, College of Natural Resources, North Carolina State University
Dr. Fisher-​Borne has taught social work education for over 10 years. With a longstanding interest in
health equity and intervention research, she is currently leading a cancer prevention intervention
nationally at the American Cancer Society. She chose social work as a discipline because of its
long history of applied, interdisciplinary, practice-​based research. Her overarching research goals
have been to contribute to the body of knowledge that helps practitioners to understand how
interventions focused on structural change impact health outcomes for marginalized populations.
Specifically, her work has focused on developing and evaluating health interventions that build
community and organizational partnerships to tackle health inequalities in the United States
and Global South (i.e., Central America and Asia). Through a competitive process in 2013,
Dr. Fisher-​Borne was awarded a contract from the American Cancer Society to assess the impact
of community health advisers on reducing cancer disparities. The Cancer Disparities Reduction
Collaborative is modeled on an evidence-​based intervention from the Deep South Network for
Cancer Control. She was contracted to evaluate the three-​year pilot phase of intervention in the
Deep South, in Appalachia and with the Eastern Band of the Cherokee Nation.

About the Contributors • xv

xvi

Megan Gandy-​Guedes, PhD

Assistant Professor, Anne and Henry Zarrow School of Social Work, University of Oklahoma
Dr. Gandy-​Guedes graduated with her MSW from the University of North Carolina-​Charlotte and
practiced as a licensed clinical social worker with children, adolescents, and adults with serious
mental illness in both community and inpatient settings for more than six years before returning
to school for her PhD at the School of Social Work at Virginia Commonwealth University in
Richmond. In addition to her role as assistant professor at the Anne and Henry Zarrow School
of Social Work at the University of Oklahoma (OU), she holds core affiliate faculty status with
the OU Department of Women’s and Gender Studies and is a faculty associate with the OU Knee
Center for Strong Families. Her substantive area of research interest is LGBTQ populations,
focusing primarily on mental health and service use, faith communities and social support, and
social justice issues. Her scholarship includes the Queer Youth Cultural Competency scale, an
instrument to measure LGBTQ-​related cultural competency in direct-​care behavioral health
workers. She also explores how faith communities act as protective factors in the lives of LGBTQ
people. Her teaching interests include direct clinical practice with individuals, groups, and families.
Dr. Gandy-​Guedes is involved at the grassroots level in community advocacy for LGBTQ people
through a citizen-​led initiative called Norman United.
Trevor G. Gates, PhD, LCSW
Assistant Professor, Social Work, Greater Rochester Collaborative MSW Program, College at Brockport,
State University of New York
Dr. Gates holds a PhD in social work with an interdisciplinary certificate in gender and women’s
studies from the University of Illinois at Chicago. He is a clinical social worker and substance
abuse counselor with more than 12 years of experience in community-​based and hospital settings,
specializing in practice with LGBTQ communities. His current research focuses on social justice
issues with LGBTQ communities, organizational behavior, and strengths-​based practices. He is
currently conducting empirical research on the impact of workplace stigma-​related experiences on
LGBTQ people and the correlation of organizational tolerance for heterosexism and individual/​
organizational wellness. He is also interested in international issues, especially human rights issues
for LGBTQ workers.
Eric Hartman, DSW, LCSW
Private Practitioner
Dr. Hartman maintains a full-​time independent psychotherapy practice in New York City. After
receiving his Master of Social Work from New York University (NYU), he joined a community-​
based organization that serves homeless and street-​involved LGBTQ youth, where he worked
in various clinical and administrative roles over the span of six years. During that time, he also
completed an intensive clinical training program at the Psychoanalytic Psychotherapy Study Center
in NYC. Subsequently, he earned a Doctor of Social Work (DSW) from Rutgers University, where
his research interests included the investigation of embodied identity practices and dissociative
experiences in gay men who grew up as effeminate boys. He is a recurrent invited lecturer on the
topic of dissociation at NYU and Hunter College, and he teaches a course on phenomenology in
the DSW Program at Rutgers University.

xvi • About the Contributors

xvi

Kirsten Havig, MSW, PhD

Assistant Professor, Division of Social Work, University of Wyoming
Dr. Havig is an assistant professor of social work at the University of Wyoming, where she
teaches courses on diversity and social justice, social welfare policy, administration, and
clinical practice. Prior to accepting her position in Wyoming, Dr. Havig spent five years at the
University of Oklahoma and served two years as a clinical instructor under the Federal Title
IV-​E Child Welfare training grant at the University of Missouri where she provided classroom
instruction and other training around child sexual abuse and exploitation, child welfare policy,
and children with sexual behavior problems. Her current research focuses on the commercial
sexual exploitation of children; trauma, resilience, and posttraumatic growth; child welfare
systems; and social justice pedagogy in social work education. She is a former faculty associate
with the Oklahoma University Knee Center for Strong Families with funded research focused
on the intersection of sexual exploitation and the child welfare system. Prior to working
in higher education she was a licensed clinical social worker who practiced primarily with
justice-​involved youth and survivors of sexual trauma doing therapy, forensic interviewing,
and advocacy work.
Lynn C. Holley, PhD, ACSW
Associate Professor, School of Social Work, Arizona State University
Dr. Holley is an associate professor in the School of Social Work at Arizona State University. She
has conducted multicultural feminist research about diversity and oppression of several identity
groups. Her current focus is on oppression of people with mental health conditions, including
those who are of color and/​or LGBTQ. She enjoys teaching and mentoring BSW, MSW, and PhD
students. She earned her MSSW from the University of Tennessee at Knoxville and her PhD from
the University of Washington at Seattle.
Ian W. Holloway, PhD, MSW, MPH
Assistant Professor, Luskin School of Public Affairs, University of California, Los Angeles
Professor Holloway’s research focuses on understanding the multilevel contexts in which
health risk and protective behaviors occur in order to inform theoretically driven, culturally
tailored structural and social network-​delivered interventions to improve the health and well-​
being of sexual-​and gender-​minority (LGBT) communities. He is the principal investigator
of a study funded by the UCLA Center for AIDS Research to understand health risk behaviors
among gay, bisexual, and other men who have sex with men in the Dominican Republic.
Dr. Holloway is also currently collaborating on two studies funded by the National Institutes
of Health. The first, titled “Social Networks and Technology Use of Transgender Women
with/​at High Risk for HIV,” focuses on understanding how the structure and composition
of transgender women’s egocentric social networks influences their engagement in HIV risk
and protective behaviors. The second, “Social Media for HIV Testing and Studying Social
Networks,” examines the efficacy of a Facebook-​delivered peer education program on HIV
testing behaviors of racially and ethnically diverse gay, bisexual, and other men who have sex
with men.

About the Contributors • xvii

xvi

Sid P. Jordan, JD
Doctoral Student, Luskin School of Public Affairs School in Social Welfare, University of California at
Los Angeles
Sid Jordan’s research and field experience has focused on the health, wellness, and self-​
determination of LGBTQ youth and survivors of violence. Mr. Jordan previously led one of the
first federally funded demonstration projects aimed at increasing access to victim services for
LGBTQ communities and has provided extensive training and consulting for health and human
service organizations in the United States and Canada. Mr. Jordan’s research interests include the
intersections of social work and the law, community-​based responses to violence and trauma, and
the criminalization of LGBTQ youth and transgender people.
Brian L. Kelly, PhD, MSW, CADC
Assistant Professor, School of Social Work, Loyola University Chicago
Dr. Kelly received his BSW, MSW, and PhD in social work from University of Illinois at Chicago, Jane
Addams College of Social Work. His research explores current and historical uses of recreational,
art, and music-​based activities in social work and related fields as sites and opportunities for
strengths-​based social work practice. He holds an associate degree in audio engineering from
Full Sail University and incorporates audio documentary and other audio-​based ethnographic
methodologies in his work as means to increase strengths-​based, participatory research practices.
Dr. Kelly has several years of clinical experience working with individuals with substance use
issues as a certified alcohol and drug abuse counselor. In addition, he has several years of practice
experience working with the homeless, including adults living with HIV/​AIDS and other chronic
medical conditions as well as young people. Dr. Kelly is an advocate for the advancement of social
work practice with groups and teaches group work and substance use courses at the graduate level.
Shaina Knepler-​Foss, MSW, CADC
Alumnus, School of Social Work, Loyola University Chicago
Ms. Knepler-​Foss, MSW, CADC, is a May 2016 graduate from the School of Social Work at
Loyola University Chicago. She specialized in mental health and the Certified Alcohol and other
Drug Counselor program. Ms. Knepler-​Foss is interested in working with diverse communities
to establish effective alternative treatments for individuals who are impacted by chemical and
process addictions. While presently employed at a psychiatric rehabilitation center, Ms. Knepler-​
Foss spends her free time crocheting and exploring Chicago with her partner Eric and dog Luther.
Gayle Mallinger, PhD, MSW
Assistant Professor, Department of Social Work, Western Kentucky University
Professor Mallinger earned her MSW and PhD in social work at the University of Pittsburgh.
Her research focuses on examining the influence of intersecting contexts on individual, family,
and community resilience. Specifically, she investigates the determinants of social injustice and
the evaluation of interventions aimed at promoting equity. Her current work is centered on the
efficacy of varied pedagogical strategies in preparing social work students to successfully practice
with LGBT client systems.

xviii • About the Contributors

xxi

Lauren B. McInroy, MSW

Doctoral Student, Factor-​Inwentash School of Social Work, University of Toronto
Ms. McInroy is a PhD candidate, research coordinator, and course instructor in the Factor-​
Inwentash Faculty of Social Work at the University of Toronto. She also holds master’s in social
work, bachelor of education, and bachelor of arts degrees from the University of Toronto and
is a registered social worker in the province of Ontario. Lauren’s research primarily focuses on
the well-​being of LGBTQ+ populations and the developmental and social implications of offline
and online information and communication technologies on children, adolescents, and young
adults. An accomplished emerging scholar with numerous publications, her dissertation research
is investigating the impact of creative, community-​driven online fan culture on the identity
development and resilience of LGBTQ+ young people.
David A. McLeod, PhD, MSW
Graduate Coordinator and Assistant Professor, Anne and Henry Zarrow School of Social Work,
University of Oklahoma
Dr. McLeod has spent the better part of the past two decades working to actively reduce violence,
particularly that directed at people and communities with diminished capacities for self-​protection.
In addition to being an assistant professor in the University of Oklahoma (OU) Anne and Henry
Zarrow School of Social Work, he holds affiliate faculty status with the OU Department of Women’s
and Gender Studies and the OU Center for Social Justice as well as being a faculty associate with
the OU Knee Center for Strong Families. A former police detective who transitioned to become a
forensic social worker, David has taught undergraduate and graduate courses in programs of social
work, criminal justice, and preparing future faculty. His research is focused on the intersection of
criminal behavior development, gender, and trauma. Some of Dr. McLeod’s current professional
activities include investigations of differential criminal behavior development, the impact of
trauma on human development, neuroscience, female sexual offending, female incarceration,
child sexual abuse, child protection and child protective service provision, intraprofessional and
multidisciplinary collaboration, and human sex trafficking.
Natasha S. Mendoza, PhD
Assistant Professor, School of Social Work, Arizona State University
Dr. Natasha Mendoza is an assistant professor in the School of Social Work at Arizona State
University (ASU). She received her MSW from the University of Wyoming and her PhD
from The Ohio State University. Prior to joining ASU, Dr. Mendoza was an National Institute
of Health–​supported postdoctoral fellow at the Research Institute on Addictions in Buffalo,
New York. Currently, Dr. Mendoza serves on the board of directors for the National Council on
Alcoholism and Drug Dependence (Phoenix). Dr. Mendoza’s scholarship is based on the premise
that motivation to change substance use behaviors is intrinsic and a function of interpersonal
relationships, occurring within the context of culture and across multiple systems (e.g., criminal
justice, child protective services). Moreover, intersecting identities (i.e., gender, ethnic, and sexual
orientation), physical health, and wellness are indelibly linked to behavioral health. Her work

About the Contributors • xix

xx

examines the ways in which identity and wellness may be an asset in recovery from substance
use disorders or connected to risk factors associated with problematic use and treatment barriers.
Aside from research, Dr. Mendoza is actively engaged in preparing students to work with members
of the LGBTQ community and build on the empirical foundation of social work with an emphasis
on evidence-​based treatment of substance use disorders.
Anthony P. Natale, MSW, PhD
Associate Professor and Assistant Director, Anne and Henry Zarrow School of Social Work, University
of Oklahoma
Dr. Natale is a PhD graduate from the University of Denver, Graduate School of Social Work and
obtained a master of social work degree from Portland State University. His social work practice
background includes community-​based clinical social work, crisis mental health services, and
employee assistance program delivery. Dr. Natale’s primary scholarly interests include health
disparities, HIV/​AIDS, trauma and human development, social determinants of health, and social
and public health policy.
John Orwat, PhD, LCSW
Associate Professor, School of Social Work, Loyola University Chicago
Dr. Orwat is an associate professor in the School of Social Work at Loyola University Chicago. He
teaches health policy and systems in the MSW program and advanced statistics in the doctoral
program. Dr. Orwat is principal investigator for the Interprofessional Practice with at-​Risk
Youth project, funded by the Health Resources and Services Administration, and co-​principal
investigator for the Screening, Brief Intervention and Referral to Treatment project, funded by
Substance Abuse and Mental Health Services Administration, both at Loyola University Chicago.
He has also led several health services research projects, most recently an analysis of physician
quality in urban versus rural areas. Dr. Orwat holds a PhD from the Heller School of Social Policy
and Management at Brandeis University and a master of arts in clinical social work from the
University of Chicago, School of Social Service Administration.
G. Allen Ratliff, MSW, LCSW
Doctoral Student, University of California-​Berkeley School of Social Welfare
Mr. Ratliff previously worked as the director of clinical services at the Youth Service Project,
a social service agency on the west side of Chicago, and is a licensed clinical social worker in
the state of Illinois. Mr. Ratliff received his BA in sociology and English from the University
of Nebraska-​Lincoln and his MSW from the University of Illinois at Chicago. Mr. Ratliff
has several years of clinical experience working with queer, gender-​nonconforming, and/​or
homeless young people and with youth and families affected by community violence. His
research is centered on the experiences of queer and gender-​nonconforming children and
adolescents, with particular emphasis on the impacts of microaggressions on developmental
milestones and long-​term outcomes in health, education, and relationships. In his clinical
practice and supervision Mr. Ratliff advocates the use of trauma-​informed, harm reduction,
positive youth development practices with young people affected by community violence,
trauma, and discrimination.

xx • About the Contributors

xxi

Elizabeth B. Russell, PhD, LCSW, MSW

Clinical Associate Professor, Social Work, Greater Rochester Collaborative MSW Program, College at
Brockport, State University of New York
Dr. Russell is currently a clinical associate professor at the College at Brockport, State University
and was previously a tenured associate professor at Nazareth College. She has worked in a variety
of practice settings including as a case manager for the chronically mentally ill, a clinical social
worker in a university hospital outpatient setting, a child therapist, a sex therapist, a clinical
supervisor, and a researcher at two other universities. Her main areas of interest are sexual health
in practice settings, community advocacy for social justice, women and depression, and mental
health. Her current research focuses on the sexual health training of social workers, online
curriculum development and delivery, and women in academia. Dr. Russell received her PhD
from the University of Rochester and her master of social work degree from the University of
Michigan-​Ann Arbor where she majored in interpersonal practice and sexual health. Her doctoral
dissertation assessed mental health practitioners’ knowledge, attitudes, and training in sexual
health.
Kristin S. Scherrer, PhD, LCSW, MA
Associate Professor and BSSW Program Director, Department of Social Work, Metropolitan State
University of Denver
Dr. Scherrer received her PhD in social work and sociology, as well as her MSW and MA in
sociology from the University of Michigan and her BA in sociology and psychology from the
University of Colorado at Boulder. Dr. Scherrer’s research examines how age, generation, and
cohort shape how individuals recognize themselves as having sexual-​minority identities and
how these identities affect their family relationships. Most recently, she investigated how family
systems, and grandparent–​grandchild relationships in particular, are affected by the discovery of
a grandchild’s LGBQ sexual orientation. Other research interests include bisexual and asexual
identities, culturally competent practice, and gerontology. Dr. Scherrer’s practice experiences
have involved working with LGBQT individuals and their families, women and children who were
victims of violence, and older adults and their families. Across these roles, Dr. Scherrer’s clinical
work has focused on how individuals and families cope with conflict and crisis. Dr. Scherrer has
taught social work courses at MSU Denver, Rutgers University, and the University of Michigan, in
content areas such as social work practice, diversity, advanced clinical practice with older adults,
LGBT issues, international social work, group dynamics, aging and gerontological services,
qualitative research, and women’s issues.
Mark Smith, PhD, LCSW
Associate Professor, School of Social Work, Barry University
Dr. Smith has been a social work faculty member at Barry University for 14 years and holds the
rank of associate professor. His undergraduate degree is in early childhood education (University
of South Carolina) and his MSW is from San Francisco State University. He maintains a small
practice specializing in clinical supervision and narrative-​based work with adults, adolescents,
children, and families. Dr. Smith’s areas of interest and expertise include resiliency-​focused clinical

About the Contributors • xxi

xxi

practice, social group work, family practice, community responses to disaster and trauma, LGBTQ
youth and adults, international social work and social development, antiracist/​oppressive social
work pedagogy, narrative and constructivist clinical practice, spirituality, and participant-​based
qualitative research. He is currently a member of the board of directors for the International
Association for Social Work with Groups.
Marcia Spira, PhD
Professor and Interim Associate Dean, School of Social Work, Loyola University Chicago
Dr. Spira coordinates the gero subspecialization program in the master of social work program.
She teaches classes in human behavior and direct practice to students in the master’s and doctoral
programs. She earned her PhD in 1982 from the University of Chicago where she studied the
impact of a chronic illness on family relationships. Dr. Spira has published many articles and
presented at local and national conferences on individuals and families confronted with challenges
and transitions throughout the life cycle. Her most recent work focuses on the shifts that occur in
families challenged with the diagnosis of dementia. She also maintains a private practice.
De’Shay Thomas, MSW
Doctoral Student, School of Social Work, Arizona State University
De’Shay is a third-​year doctoral student in the School of Social Work at Arizona State University.
She received a BA in social work from San Diego State University and her master’s degree in social
work from California State University, Los Angeles. Ms. Thomas worked as a doctoral research
intern and graduate research associate with the Southwest Interdisciplinary Research Center,
where her work was centered in ethnic/​racial minorities’ health disparities in urban and rural
communities. Her current research interests include behavioral health disparities, particularly in
ethnic-​, gender-​, and sexual-​minority communities. She aims to understand how social-​cultural
ideologies influence help-​seeking processes while utilizing intersectionality and a Black feminist/​
womanist perspective.
Pamela A. Viggiani, PhD, LMSW
Associate Professor, Social Work, Greater Rochester Collaborative MSW Program, College at Brockport,
State University of New York
Dr. Viggiani is currently an associate professor at the College at Brockport, State University of
New York. She has worked in a variety of practice settings including working with at-​risk elementary
and middle school children and as the legislation director at the New York State chapter of the
National Association of Social Workers. Her main areas of interest are oppression and privilege,
cultural humility, advocacy and social justice, and children and families with disabilities. Her
current research focuses on best practices for teaching cultural humility to social workers and
health-​care professionals and on practitioner–​client relationships with refugee families that have
children with disabilities. Dr. Viggiani received her PhD and her MSW from the State University
of New York at Albany.
M. Alex Wagaman, PhD
Assistant Professor, School of Social Work, Virginia Commonwealth University
Dr. Wagaman received her PhD and MSW from Arizona State University. She has more than
10 years of practice experience in neighborhood and community organizing and community-​based

xxii • About the Contributors

xxi

anti-​oppression education work. Dr. Wagaman has been actively involved in LGBTQ organizations
and advocacy for two decades. Her research interests include participatory research and social
service approaches for adolescents and young adults who are members of populations that face
oppression and marginalization, including LGBTQ youth; community-​based research needs
of LGBTQ youth organizations; critical methodologies; and qualitative research methods.
Dr. Wagaman’s teaching interests include macro practice and social welfare policy.
Courtney Wilson, MSW
Alumnus, School of Social Work, Loyola University Chicago
Ms. Wilson, MSW, is a May 2016 graduate from the School of Social Work at Loyola University
Chicago, where she specialized in the mental health program and co-​chaired the Social Work
Student Organization's LGBTQ committee. Ms. Wilson is interested in working with LGBTQ
individuals, especially those experiencing complex trauma and substance abuse. Ms. Wilson
spends her free time sewing and exploring Chicago on her bicycle.
Sarah R. Young, PhD, MSW
Assistant Professor, Department of Social Work, Binghamton University
Dr. Young received her PhD in social work from the University of Alabama and her MSW with a
focus in community organizing from the University of Michigan. Born and raised in a rural town
in upstate New York, Sarah fell in love with the Deep South and lived in Mississippi from 2008
to 2012 working as an LGBTQ youth organizer. She is co-​founder and former program manager
of the Mississippi Safe Schools Coalition, a youth-​led LGBTQ youth advocacy group working
to make school climate safer for LGBTQ youth. Dr. Young has served as adjunct faculty in the
social work departments of both Mississippi State University and the University of Alabama at
Birmingham. She is a former Point Foundation Scholar and was selected by the White House as
an Emerging LGBTQ Leader; her dissertation focused on expanding safe schools protections for
LGBTQ youth in the Deep South. Her research focuses on LGBTQ policy, community organizing
in conservative and underresourced areas, and supporting the families of LGBTQ youth. She is
currently an assistant professor at Binghamton University.

About the Contributors • xxiii

xvi
xv

INTRODUCTION

W elcome to the first edition of Social Work Practice with the LGBTQ
Community: The Intersection of History, Health, Mental Health and Policy Factors published by Oxford
University Press. It has been such an honor in my role as both editor and author to complete this proj-
ect, a true labor of love for all those involved. The authors combined knowledge in the field of social
work and academia spans decades of direct experience in practice, policy, and research across the
United States and Canada related to work with lesbian, gay, bisexual, transgender, and queer (LGBTQ)
populations. There are so many unique aspects to this text far beyond understanding the long history
of challenges faced by members of the LGBTQ community—​along with acknowledging recent suc-
cess and progress pertaining to the ongoing movement for equality. The authors have woven in inter-
national concerns and content associated with the LGBTQ movement and ongoing needs related to
health, mental health, policy, and advocacy, among other areas of concern. Our hope was to have the
content be applicable and useful for social work students and practitioners across the allied health and
mental health professions as well as across disciplines. While each chapter has been led by members of
social work faculty, there are many co-​authors including doctoral and graduate students. The institu-
tions and schools represent those from large urban cities and small rural towns across the United States
and Canada. We attempt to examine the lens of practice in several ways while including relevant con-
ceptual literature along with current empirical research in the field of LGBTQ health and mental health.
The text is broken up into five unique sections that include Section I: Overview: Building Knowledge
for Practice; Section II: Considerations Across the Lifespan; Section III: Affirming LGBTQ Practice
Approaches; Section IV: Health and Mental Health Factors; and Section V: Appendices. Highlights
of the chapters include the following: (a) narrative that blends conceptual, theoretical, and empirical
content; (b) examination of current trends in the field related to practice considerations; and (c) snap-
shots of concerns related to international progress and ongoing challenges related to equality and pol-
icy. The supplemental appendices included at the end of the text that include (a) signs, symbols, and
subcultures; (b) notable and historical LGBTQ individuals; (c) important historical events and policy
related issues; and (d) national resources, websites, and weblinks.
Additionally, as a classroom support for instructors, each chapter has a corresponding
Powerpoint presentation that includes a resource list pertaining to that chapter’s focus with
xvi

websites, film, and video links as well as national and international organizations associated with
the LGBTQ community. In addition to the resources, each Powerpoint presentation includes up
to two case scenarios that directly relate to the chapter content for instructors to build on and use
in class or for homework assignments.
As you read this text, it will be important to realize that practice and policy factors facing the
LGBTQ community across the United States and international communities are changing daily.
At the time of this writing, following soon after the results of the recent US presidential election,
many of us await any potential challenges made that counter recent progress. Therefore, we suggest
that you continue to seek current resources to supplement the time in which this text was written
in order to best meet the needs of this widely diverse community; along with your continued edu-
cation and developing competency, and to meet the needs of students in the classroom and field
alike. Staying current assists with understanding most recent celebrations and accomplishments
(e.g., US marriage equality and adoption laws) as well as the need to continue advocating for the
ongoing promotion of social justice associated with other inequalities (e.g., employment; hous-
ing; immigration discrimination; hate crime laws; transgender rights; international policies; and
ongoing forms of oppression). Thus whether you are a member of the LGBTQ community or an
ally, there is great room for collaboration in supporting the ever-​changing needs of this minority
population within classroom settings, organizations, private practice, and far beyond.
A text such as this cannot be completed without ample acknowledgements and gratitude for
all those involved throughout the various stages of publication. First it is important to acknowl-
edge the hard work and collegiality of each of the authors within this text. It was an honor and
privilege to work with so many esteemed colleagues. Second, I would also like to acknowledge
my Practice with the LGBTQ Community class at Loyola University Chicago from the fall 2016
semester. They completed a critical review of all chapters and Powerpoint presentations as one of
their class assignments, giving invaluable feedback to truly strengthen the overall content and flow
from a social work student’s perspective. Next, it was approximately two years ago at the annual
program meeting of the Council on Social Work Education in Washington, D.C., that I met Dana
Bliss with Oxford University Press. When I inquired about whether Oxford had a text on practice
with the LGBTQ community, he replied: “No, but you should write one!” Well Dana—​at long
last—​here it is! I owe him much gratitude for his unwavering support and guidance all along the
way, along with the entire team at OUP. Thanks to my graduate assistant and amazing MSW/​
MA student Nikki Busch for all her work in the final stages of editing and submission, and also to
my research assistant and doctoral student Melissa Iverson for her moral support along the way.
A special thank you to many other folks that provided so much guidance, feedback, and support in
countless ways, especially Edward Alessi, Tyler Argüello, Ashley Austin, Shelley Craig, Domingo
Gonzales III, Susan Grossman, Brian Kelly, Marta Lundy, Denise Mather, Lori Messinger, Jason
McVicker, Anthony Natale, John Orwat, Susan Wardzala, Darrell Wheeler, Courtney Wilson, my
colleagues at the School of Social Work at Loyola University Chicago, and most importantly the
many social work students who have inspired me over the years.
Michael P. Dentato, PhD, MSW, Editor
April 15, 2017
Chicago, IL

xxvi • Introduction
xxvi

SOCIAL WORK PRACTICE WITH

THE LGBTQ COMMUNITY
xxvii
1

PART I

OVERVIEW
Building Knowledge for Practice
2
3

CHAPTER 1

A HISTORY OF COMMUNITY
Marching Toward LGBTQ Equality

Jean E. Balestrery

INTRODUCTION
It was a watershed moment for the lesbian, gay, bisexual, transgender, and queer (LGBTQ) com-
munity in 2015 when the US Supreme Court ruled in favor of legalizing same-​sex marriage in the
case of Obergefell v. Hodges. “In a long-​sought victory for the gay rights movement, the Supreme
Court ruled by a 5-​4 vote . . . that the Constitution guarantees a right to same-​sex marriage. ‘No
longer may this liberty be denied,’ Justice Anthony M. Kennedy wrote for the majority in the
historic decision. ‘No union is more profound than marriage, for it embodies the highest ideals
of love, fidelity, devotion, sacrifice and family. In forming a marital union, two people become
something greater than once they were’ ” (Liptak, 2015). Culminating after many decades-​long
struggles, the LGBTQ community in the United States celebrated this success as a huge victory
for human rights. However, the status of LGBTQ human rights, both legally and socially, varies
widely across the globe.
This chapter charts the history of the LGBTQ movement and community. First, a contempo-
rary global context relevant to LGBTQ people is presented. Next, this chapter identifies threads
of an emerging LGBTQ social movement, which occur in relation to other social developments
and movements during the nineteenth and twentieth centuries. Then review of the work of social
scientists studying sex, or sexology, depicts a sociopolitical climate of ideological contestations
occurring in association with the sex, sexuality, and gender systems. These contestations reflect co-​
constituting discourses in the United States and abroad that led to institutional developments for
LGBTQ advocacy. Following such developments, this chapter describes important events includ-
ing the 1969 Stonewall uprising and assassination of Harvey Milk that forwarded the modern
LGBTQ movement. This chapter concludes with a look at ongoing celebrations and challenges
relevant to LGBTQ people and communities.
4

THE C ONTEMPORARY GLOBAL C ONTEXT

A person’s country of citizenship and place of residence can determine whether same-​sex mar-
riage is a legal option or whether same-​sex behavior is a criminal offense. According to the United
Nations, “in some 77 countries, discriminatory laws criminalize private, consensual same-​sex
relationships—​exposing individuals to the risk of arrest, prosecution, imprisonment—​even, in
at least five countries, the death penalty” (United Nations Office of the High Commissioner for
Human Rights [OHCHR], n.d.). The global context is marked by a wide array of legalization, dis-
crimination, and criminalization with regard to the issue of sexual orientation and gender identity.
A 2013 Pew Research Center survey of publics in 39 countries found huge variance by region on
the broader issue of acceptance or rejection of the LGBTQ community. The United States is among
many other countries across the globe, such as those in Europe and the Americas, that legally sup-
port same-​sex marriage and more generally the LGBTQ community. However, such progress in
the United States occurred in 2013 with the case of U.S. v. Windsor overturning the Defense of
Marriage Act (DOMA), a 1996 federal law defining marriage as a union between one man and one
woman and also allowing other states to not recognize same-​sex marriage granted under the laws
of other states. According to President Obama, DOMA “violated the Fifth Amendment’s guaran-
tee of equal protection” ( Johnsen, 2013, p. 599). In the same regard, many countries still do not
support same-​sex marriage or more generally the LGBTQ community; among these are Muslim
nations, Africa, Russia, and parts of Asia (Pew Research Center, 2015).
Russia, for example, is currently entertaining a new anti-​LGBTQ bill that is being proposed
in parliament, which follows a “gay propaganda” bill passed in 2013 (Editorial Board, 2016). This
new bill “proposes fines of between four and five thousand rubles (USD $53–​$66) for ‘the public
expression of non-​traditional sexual relations, manifested in a public demonstration of personal
perverted sexual preferences in public places’ ”; further, this bill states that if such public expres-
sion occur “ ‘on territories and in institutions, providing educational, cultural or youth services,’
the offender could face an additional penalty of up to 15 days of administrative arrest” (Cooper,
2016). Through fines and jail time, this new bill criminalizes the public expression of LGBTQ
behavior. Ivan Nikitchuk, one of the lawmakers introducing the bill, described it as “an effort to
preserve longstanding social norms” (Editorial Board, 2016).
Despite President Putin’s insistence that Russia is a safe country for LGBTQ people, this pro-
posed new bill further threatens the safety of LGBTQ people. “Human Rights Watch documented
a rise in harassment of gay people and violent attacks after passage of the 2013 law, which outlawed
promotion of what the government classified as ‘nontraditional sexual relationships’ ” (Editorial
Board, 2016). Reporting for Human Rights Watch, researcher Tanya Cooper noted: “If the mem-
bers of parliament have any regard at all for the country’s constitution and international human
rights obligations, they know that they should immediately reject this bill.” President Putin signed
the 2013 propaganda bill into law yet also has publicly denied that Russia has institutionalized
homophobia. Prior to the 2014 Winter Olympics in Sochi, Putin “sought to dispel concerns that
gay athletes and spectators could be vulnerable” and later stated: “[w]‌e have no persecution at
all”—​which was clearly not true (Editorial Press, 2016).
Yet, even in countries where same-​sex marriage is legal, discrimination toward LGBTQ peo-
ple continues—​in some cases sexual and gender minorities can be assaulted, victimized, and

4 • Social Work Practice with the LGBTQ Community

5

murdered. Argentina is one such example; it legalized same-​sex marriage in 2010, thus becom-
ing the first Latin American country to do so. Argentina is a country in the Americas with some
of the most liberal civil rights policies. For example, in 2012 the country passed gender identity
legislation that supports gender-​identity transitions without a psychiatric diagnosis or surgery
(Gilbert, 2015). Despite the passage of this gender identity law, social hostility and unsolved mur-
ders of transgender people continue. In fact, it is troubling to note that the average life expectancy
of transgender people in Argentina is only 35 years. Notably, activist messages such as “Enough
transgendercide” and “Liberate us from violence” were visible at a 2015 LGBTQ march in Buenos
Aires (Gilbert, 2015).
In Southeast Asia, Vietnam’s communist government abolished a ban on same-​sex marriage
on New Year’s Day in 2015 (Lewis, 2016). Yet discrimination toward LGBTQ people continues.
Soon after this ban was lifted, reports were published about “ongoing insults, intimidation and
beatings that young LGBT people are subjected to in the country’s schools” (Lewis, 2016). For
example, last year, a UNESCO report “on bullying on the basis of sexual orientation and gender
identity across the Asia-​Pacific referred to recent studies finding that almost half of LGBT students
in Vietnam said they faced serious stigma in schools” (Lewis, 2016).
The United Nations has written an official position statement on the topic of LGBTQ rights.
In 2011, the Human Rights Council adopted the first United Nations resolution on sexual ori-
entation and gender identity known as Resolution 17/​19. Following the adoption of this resolu-
tion, the OHCHR developed the first official United Nations report on the issue. By doing so,
the United Nations was “expressing ‘grave concern’ at violence and discrimination against indi-
viduals based on their sexual orientation and gender identity” (United Nations OHCHR, n.d.).
In September of 2015, 12 United Nations entities jointly developed an unprecedented statement
to serve as a public call to end such violence and discrimination. In particular, this statement was a
call to action aimed toward governmental bodies. At an international level, the OHCHR

is committed to working with states, national human rights institutions and civil society
to achieve progress towards the worldwide repeal of laws criminalizing LGBT persons and
further measures to protect people from violence and discrimination on grounds of their
sexual orientation or gender identity. (United Nations OHCHR, n.d.)

IMBRI CAT ING SO C I AL MOVEMENTS

In the profession of social work, it is notable that lesbians were among the first generation of women
leaders and activists for human rights, including Jane Addams, Ellen Star, and Mary Richmond.
Now referred to as “lesbian foremothers,” such recognition counters the erasure of sexuality in the
historical record of the profession (Fredrikson-​Goldsen, Lindhorst, Kemp, & Walters, 2009) as
well as noting the critical role of social workers within various social movements. It should be
noted that while engaged in various forms of same-​sex intimacy and relationships, these women
activists would likely not have used the contemporary term “lesbian” to self-​identify during that
historical period (circa 1880s–​1920s). Regardless, the impact these and many other lesbian,
bisexual, and transgender women had on social movements addressing poverty, equal rights (e.g.,

A History of Community • 5
6

women, race, LGBTQ), and social justice across time must not be underestimated nor overlooked.
As noted by Mary Richmond: “Movements more or less independent in origin may act and react
upon one another in such a way as to make it difficult to unravel their beginnings” (1917, p. 33).
In the same regard, the LGBTQ movement is intertwined with other social movements occur-
ring during the late nineteenth and early twentieth centuries throughout the United States and
Europe. Among these are social Darwinism, eugenics, and moral reform campaigns. Inscribed
within such movements were many labels, sexual acts, bodily characteristics, and roles deemed
as sexual perversions. Such behaviors and alleged perversions were “linked to increasing anxi-
ety about the nature of civilization and evolutionary ‘progress’ ” (Gibson, 1997, pp. 111–​112).
Theories of degeneracy and pathology permeated these social movements and “[h]‌omosexuality
was almost invariably labeled as a form of degeneration” (Gibson, 1997, p. 115). Odem (1995)
helps us to further understand the intersection of societal events, perceptions, and the LGBTQ
movement when noting

Expressions of sexuality that did not conform to a marital, reproductive framework were
increasingly subjected to government surveillance and control, as evidenced by a range of
legal measures . . . [including] legislation prohibiting the dissemination of obscene litera-
ture, the criminalization of abortion, stringent measures targeting prostitution, and height-
ened legal repression of homosexuality. Such developments reflected Americans’ deep
anxiety about the increased potential for sexual expression outside of marriage—​a situa-
tion that threatened middle-​class Victorian ideals of sexual restraint and marital, reproduc-
tive sex. (p. 2)

Many of the laws associated with sex and sexuality in the United States date back to the nineteenth-​
century morality crusades with the passage of the first anti-​obscenity law known as the Comstock
Act of 1873. This act was followed by the Criminal Law Amendment Act of 1885, the Mann Act
of 1910, the utilization of systematized categories during the 1950s such as “sex offender” and
“child abuse,” and laws circumscribing sexual behavior that contained jurisdictional power that
functioned to criminalize homosexuality and the “homosexual” (Rubin, 1993, pp. 4–​5).
The criminalization of homosexuality in the United States continued throughout the twen-
tieth century, and the theory of pathology associated with “homosexuality” was codified in
the emblematic “sexual psychopath” stereotyping that occurred during the 1930s. In 1952, the
American Psychiatric Association (APA) published the first Diagnostic and Statistical Manual of
Mental Disorders to classify sexual perversity and, later, “homosexuality” as clinically diagnosable
disorders or “abnormal” conditions. It was not until 1973 and through the petitioning and activ-
ism of key LGBTQ leaders such as Barbara Gittings and Frank Kameny that the APA removed
“homosexuality” from the manual.
Antisodomy laws provided another form of criminalizing the LGBTQ community. In fact, as
of 1960 every state had an antisodomy law on record (Associated Press, 2003). It was not until
the landmark case of Lawrence v. Texas in 2003 when the US Supreme Court ruled against a ban
on same-​sex sexual activity. The Supreme Court’s decision striking down the sodomy law in Texas
ruled: “that the law was an unconstitutional violation of privacy” (Associated Press, 2003). In
doing so, the Supreme Court made same-​sex sexual activity legal in every state and territory

6 • Social Work Practice with the LGBTQ Community

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